Provider Demographics
NPI:1336251313
Name:SWEET, PAULA J (CRNP)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:J
Last Name:SWEET
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:J
Other - Last Name:BRASE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:691 COUNTY ROAD 264
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35056
Mailing Address - Country:US
Mailing Address - Phone:256-388-1599
Mailing Address - Fax:
Practice Address - Street 1:1100 7TH AVENUE
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501
Practice Address - Country:US
Practice Address - Phone:205-302-9000
Practice Address - Fax:205-387-8270
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-044848363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
51557190OtherBC/BS OF AL
P62303Medicare UPIN
051557190BRAMedicare ID - Type Unspecified